EURORAD ESR

Case 9451

Wilkie's syndrome

Author(s)
Perdikakis E, Ntitsias T, Kofinas A

General Military Hospital, Department of Radiology;
Terma Lefkou Pyrgou 67100 Xanthi, Greece;
Email:perdikakis_ev@yahoo.gr
 
Patient
male, 30 year(s)
 
 
  • Figure 1
    Physical examination
     

    During the clinical evaluation the patient experiences severe epigastric pain in the upright position.

     
    Area of Interest: Abdomen;

    The patient reported improvement during forward leaning (curved arrow) and by taking a knee-chest position.

     
    Area of Interest: Abdomen;
     
     
  • Figure 2
    Ultrasound examination

    The transverse US image shows the aorta (thick white arrow), the SMA (thin white arrow), the intervening duodenum (yellow arrow) and a left sided IVC (asterisk).

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound;
     
     
  • Figure 3
    Colour Doppler Ultrasound

    The longitudinal US images show the acute angle between the aorta (thick arrow-thick dashed line) and the SMA (thin arrow-small dashed line). Note the intervening-compressed duodenum (yellow arrow).

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound-Colour Doppler;
     
     
  • Figure 4
    Upper gastrointestinal fluoroscopic examination

    The radiograph from an upper GI series demonstrates a stenosis in the third portion of the duodenum (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: Fluoroscopy;
     
     
  • Figure 5
    CT examination
     

    The axial contrast-enhanced CT image reveals the compression of the duodenum (yellow arrow) between the aorta (thick white arrow) and the SMA (thin white arrow). Note the left sided IVC (asterisk).

     
    Area of Interest: Abdomen; Imaging Technique: CT;

    The axial contrast enhanced CT image reveals the compression of the duodenum (yellow arrow) between the aorta (thick white arrow) and the SMA (thin white arrow).Note the left sided IVC (asterisk).

     
    Area of Interest: Abdomen; Imaging Technique: CT;
     
     
  • Figure 6
    Correlation of imaging findings

    The correlation of imaging findings confirms the duodenal compression (yellow dashed line-arrow) between the aorta (thick white arrow) and the SMA (thin white arrow). The left sided IVC is marked with the asterisk.

     
    Area of Interest: Abdomen;
     
     
During the clinical evaluation the patient experiences severe epigastric pain in the upright position.
 
The patient reported improvement during forward leaning (curved arrow) and by taking a knee-chest position.
 
The transverse US image shows the aorta (thick white arrow), the SMA (thin white arrow), the intervening duodenum (yellow arrow) and a left sided IVC (asterisk).
 
The longitudinal US images show the acute angle between the aorta (thick arrow-thick dashed line) and the SMA (thin arrow-small dashed line). Note the intervening-compressed duodenum (yellow arrow).
 
The radiograph from an upper GI series demonstrates a stenosis in the third portion of the duodenum (arrow).
 
The axial contrast-enhanced CT image reveals the compression of the duodenum (yellow arrow) between the aorta (thick white arrow) and the SMA (thin white arrow). Note the left sided IVC (asterisk).
 
The axial contrast enhanced CT image reveals the compression of the duodenum (yellow arrow) between the aorta (thick white arrow) and the SMA (thin white arrow).Note the left sided IVC (asterisk).
 
The correlation of imaging findings confirms the duodenal compression (yellow dashed line-arrow) between the aorta (thick white arrow) and the SMA (thin white arrow). The left sided IVC is marked with the asterisk.
 
 
 
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